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Background: Studies have shown inconsistent results regarding the association between
circulating osteoprotegerin (OPG) levels and all-cause mortality in patients with chronic kidney
disease (CKD). The aim of this meta-analysis is to investigate the association between circulating
OPG levels and all-cause mortality in patients with CKD.
Methods: The PubMed, EMBASE and Cochrane Library databases were searched for eligible
studies investigating the association between circulating OPG levels and all-cause mortality in
patients with CKD. Pooled hazard ratios (HRs) and the corresponding 95% confidence intervals
(CIs) were calculated using a random effects model.
Results: In all, 13 studies that included 2,895 patients with CKD were included in this analysis.
According to the meta-analysis, patients with the highest circulating OPG level had a significantly
higher risk of all-cause mortality (7 studies; the adjusted HR, 1.88; 95% CI, 1.45 – 2.44) compared
with patients with the lower circulating OPG level. An increase of 1 pmol/L in the circulating OPG
level was associated with a 6% increased risk of all-cause mortality (7 studies; the adjusted HR, 1.06;
95% CI, 1.03–1.10). A subgroup analysis by dialysis methods suggested that an elevated circulating
OPG level was independently associated with all-cause mortality in the HD only population.
Conclusion: Elevated circulating OPG levels independently predict an increased risk of all-cause
mortality in patients with CKD, especially in the HD only population